title: Commercial aircraft repatriation of patients with pneumothorax.
abstract: The transfer of patients with a pneumothorax via a commercial airline involves many medical, aeronautic, and regulatory considerations. In an attempt to further investigate these issues, we reviewed the medical records of 32 patient cases with a pneumothorax who were repatriated on commercial aircrafts. Sixteen patients were transferred with the thoracostomy tube in place and were escorted by medical personnel at an average of 5 days (interquartile range [IQR], 4-7 days) from diagnosis. Five patients without initial intercostal drainage (who either showed very limited air collection or underwent immediate surgical treatment) were all escorted by a physician at an average of 24 days (IQR, 18-25 days) of diagnosis. Eleven patients were transferred without medical escort aboard a commercial flight after removal of the chest tube at an average of 15 days (IQR, 9-17 days) of the diagnosis. This case review suggests that physicians recommend and follow markedly different management plans for the patient with a pneumothorax who is being transferred nonurgently by a commercial airliner. This differing practice management also is noted in the various existing specialty and industry guidelines, which are not evidence based; our review shows that poor agreement exists not only in these various guidelines but also among medical practitioners.
authors.affiliation: Mondial Assistance France, Paris, France. francois-xavier.duchateau@mondial-assistance.fr
authors.forename: Francois-Xavier
authors.initials: FX
authors.lastname: Duchateau
authors.forename: Jean-Michel
authors.initials: JM
authors.lastname: Legrand
authors.forename: Laurent
authors.initials: L
authors.lastname: Verner
authors.forename: William J
authors.initials: WJ
authors.lastname: Brady
mesh_terms: D000328:Adult; D064870:Air Travel; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010360:Patient Transfer / Q000379:methods; D011030:Pneumothorax; D012189:Retrospective Studies; D013907:Thoracostomy; D014187:Transportation of Patients / Q000379:methods*; D055815:Young Adult